﻿<%@ Page Language="C#" AutoEventWireup="true" MasterPageFile="~/ClinicalForms/ClinicalHeaderFooter.master"
    CodeFile="frmClinical_InitialFollowupVisit.aspx.cs" Inherits="ClinicalForms_frmClinical_InitialFollowupVisit" %>

<%@ MasterType VirtualPath="~/ClinicalForms/ClinicalHeaderFooter.master" %>
<asp:Content ID="Content1" ContentPlaceHolderID="clinicalheaderfooter" runat="Server">
   <%-- <form id="Initialfollowupvisit1" method="post" runat="server">--%>

   <div style="padding-top:1px;">
    <script language="javascript" type="text/javascript">
        function WindowPrint() {
            window.print();
        }
        function fnPageOpen(pageopen) {
            if (pageopen == "Pharmacy") {
                window.open('../Pharmacy/frmPharmacyform.aspx?opento=ArtForm');
            }
            else if (pageopen == "Labratory") {
                window.open('../Laboratory/frmLabOrder.aspx?opento=ArtForm');
            }
            else if (pageopen == "LabTest")
            {
                window.open('../Laboratory/frmLabOrderTests.aspx?opento=ArtForm');
            }
        }

        function WindowHistory() {
            history.go(-1);
            return false;
        }
        function fnchange() {
            var e = document.getElementById("<%=ddlpregnancy.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;
            

            if (strtext == "Select") {
                hide('spanEDD');
                hide('miscarriage');
                hide('Abortion');
                document.getElementById("<%=ddlFamilyPanningStatus.ClientID%>").disabled = false;
                document.getElementById("<%=txtdatemiscarriage.ClientID %>").value = "";
                document.getElementById("<%=txtdateinducedabortion.ClientID %>").value = "";
                document.getElementById("<%=txtEDD.ClientID %>").value = "";
                document.getElementById("<%=txtANCNumber.ClientID %>").value = "";
                document.getElementById("<%=chkrefpmtct.ClientID %>").checked = false;
            }
            else if (strtext == "Yes") {
                show('spanEDD');
                document.getElementById("<%=ddlFamilyPanningStatus.ClientID%>").selectedIndex = "0";
                document.getElementById("<%=ddlFamilyPanningStatus.ClientID%>").disabled = true;
                hide('divFamilyPlanningMethod');
                hide('notfamilyplanning');
                hide('miscarriage');
                hide('Abortion');
                document.getElementById("<%=txtdatemiscarriage.ClientID %>").value = "";
                document.getElementById("<%=txtdateinducedabortion.ClientID %>").value = "";
            }
            else if (strtext == "No") {
                hide('spanEDD');
                hide('miscarriage');
                hide('Abortion');
                document.getElementById("<%=ddlFamilyPanningStatus.ClientID%>").disabled = false;
                document.getElementById("<%=txtEDD.ClientID %>").value = "";
                document.getElementById("<%=txtANCNumber.ClientID %>").value = "";
                document.getElementById("<%=chkrefpmtct.ClientID %>").checked = false;
            }
            else if (strtext == "No - Induced Abortion (ab)") {
                hide('spanEDD')
                hide('miscarriage')
                show('Abortion');
                document.getElementById("<%=ddlFamilyPanningStatus.ClientID%>").disabled = false;
                document.getElementById("<%=txtEDD.ClientID %>").value = "";
                document.getElementById("<%=txtANCNumber.ClientID %>").value = "";
                document.getElementById("<%=chkrefpmtct.ClientID %>").checked = false;
            }
            else if (strtext == "No - Miscarriage (mc)") {
                show('miscarriage');
                hide('spanEDD');
                hide('Abortion');
                document.getElementById("<%=ddlFamilyPanningStatus.ClientID%>").disabled = false;
                document.getElementById("<%=txtEDD.ClientID %>").value = "";
                document.getElementById("<%=txtANCNumber.ClientID %>").value = "";
                document.getElementById("<%=chkrefpmtct.ClientID %>").checked = false;
            }
        }
        function fnfamilyplanning() {
            var e = document.getElementById("<%=ddlFamilyPanningStatus.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;

            if (strtext == "Select") {
                hide('divFamilyPlanningMethod');
                hide('notfamilyplanning');

            }
            else if (strtext == "Currently on Family Planning" || strtext == "Wants Family Planning") {
                show('divFamilyPlanningMethod');
                hide('notfamilyplanning');
            }
            else if (strtext == "Not on Family Planning") {
                show('notfamilyplanning');
                hide('divFamilyPlanningMethod');
            }
        }
        function fnTBStatus() {
            var e = document.getElementById("<%=ddlTBStatus.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;
            if (strtext == "Select") {
                hide('tbstartdate');
                hide('tbtreatment');
                document.getElementById("<%=txttbstartdate.ClientID %>").value = "";
                document.getElementById("<%=txtTBtreatmentNumber.ClientID %>").value = "";

            }
            else if (strtext == "TB Rx") {
                show('tbstartdate');
                show('tbtreatment');
            }
            else {
                hide('tbstartdate');
                hide('tbtreatment');
                document.getElementById("<%=txttbstartdate.ClientID %>").value = "";
                document.getElementById("<%=txtTBtreatmentNumber.ClientID %>").value = "";
            }
        }
        function fnSubsituations() {
            var e = document.getElementById("<%=ddlsubsituationInterruption.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;
            if (strtext == "Change regimen") {
                show('arvTherapyChange');
                hide('arvTherapyStop');

            }
            else if (strtext == "Stop treatment") {
                show('arvTherapyStop');
                hide('arvTherapyChange');
            }
            else {
                hide('arvTherapyChange');
                hide('arvTherapyStop');
            }
        }
        function fnRegimenChange() {
            var e = document.getElementById("<%=ddlArvTherapyChangeCode.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;
            if (strtext == "Other reason (specify)") {
                show('otherarvTherapyChangeCode');

            }
            else {
                hide('otherarvTherapyChangeCode');

            }
        }
        function fnStopReason() {
            var e = document.getElementById("<%=ddlArvTherapyStopCode.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;
            if (strtext == "Other (specify)") {
                show('otherarvTherapyStopCode');

            }
            else {
                hide('otherarvTherapyStopCode');

            }
        }
        function fnarvdrugother() {
            var e = document.getElementById("<%=ddlwhypoorfair.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;
            if (strtext == "Other (specify)") {
                show('divReasonARVDrugsother');

            }
            else {
                hide('divReasonARVDrugsother');

            }
        }
        function fnARVDrug() {
            var e = document.getElementById("<%=ddlarvdrugadhere.ClientID%>");
            var strtext = e.options[e.selectedIndex].text;
            
            if (strtext == "G=Good") {
                document.getElementById("<%=ddlwhypoorfair.ClientID %>").disabled = true;
            }
            else {
                document.getElementById("<%=ddlwhypoorfair.ClientID %>").disabled = false;
            }
        }
       


        function CalcualteBMI(txtBMI, txtWeight, txtHeight) {
            var weight = document.getElementById(txtWeight).value;
            var height = document.getElementById(txtHeight).value;
            if (weight == "" || height == "") {
                weight = 0;
                height = 0;
            }

            weight = parseFloat(weight);
            height = parseFloat(height);

            var BMI = weight / ((height / 100) * (height / 100));
            BMI = BMI.toFixed(2);
            document.getElementById(txtBMI).value = BMI;
        }

    </script>
    <div class="border center formbg">
        <table cellspacing="6" cellpadding="0" width="100%" border="0">
            <tbody>
                <tr>
                    <td class="border pad5 whitebg" align="center" width="50%">
                        <label class="required left" id="lblVisitDate" runat="server">
                            *Visit Date:</label>
                        <asp:TextBox ID="txtVisitDate" MaxLength="11" Columns="8" runat="server"></asp:TextBox>
                        <img height="22" alt="Date Helper" onclick="w_displayDatePicker('<%=txtVisitDate.ClientID%>');"
                            hspace="5" src="../images/cal_icon.gif" width="22" border="0">
                        <span class="smallerlabel">(DD-MMM-YYYY)</span>
                        <label>
                            If Scheduled:</label>
                        <input id="chkifschedule" type="checkbox" runat="server" />
                    </td>
                    <td class="border pad5 whitebg" align="center">
                        <label class="center">
                            Visit Type:</label>
                        <asp:DropDownList ID="ddlvisittype" runat="server">
                        </asp:DropDownList>
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg" align="center">
                        <label class="center">
                            If drug pick only, Treatment Supporter Name:
                        </label>
                        <asp:TextBox ID="txtTreatmentSupporterName" Columns="23" MaxLength="23" runat="server"></asp:TextBox>
                    </td>
                    <td class="border pad5 whitebg" align="center" valign="top">
                        <label class="center" runat="server">
                            Treatment Supporter Contact:
                        </label>
                        <asp:TextBox ID="txtTreatmentSupporterContact" Columns="23" MaxLength="23" runat="server"></asp:TextBox>
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg formcenter" align="center" colspan="2">
                        <label class="center">
                            Duration Since:</label>
                        <span class="smalllabel">ART Start</span>
                        <asp:TextBox ID="txtARTStart" CssClass="margin10" MaxLength="3" Columns="2" ReadOnly="true"
                            runat="server"></asp:TextBox>
                        <span class="smalllabel">Months</span> <span class="smalllabel margin20">Starting Current
                            Regimen</span>
                        <asp:TextBox ID="txtStartingCurrentRegimen" CssClass="margin10" MaxLength="3" Columns="2"
                            ReadOnly="true" runat="server"></asp:TextBox>
                        <span class="smalllabel">Months</span>
                    </td>
                </tr>
        </table>
    </div>
    <br>
    <div class="border center formbg">
        <br>
        <h2 class="forms" align="left">
            Clinical Status</h2>
        <table cellspacing="6" cellpadding="0" width="100%" border="0">
            <tbody>
                <tr>
                    <td class="border pad5 whitebg" colspan="2">
                        <table width="100%" border="0">
                            <tr>
                                <td align="center" style="width: 25%;">
                                    <label id="lblWeight" runat="server">
                                        Weight:</label>
                                    <asp:TextBox ID="txtPhysWeight" runat="server" MaxLength="5" Columns="4"></asp:TextBox>
                                    <span class="smallerlabel">kg</span>
                                </td>
                                <td align="center" style="width: 25%;">
                                    <label id="lblHeight" runat="server">
                                        Height:</label>
                                    <asp:TextBox ID="txtPhysHeight" runat="server" MaxLength="3" Columns="4"></asp:TextBox>
                                    <span class="smallerlabel">cm</span>
                                </td>
                                <td align="center" style="width: 25%;">
                                    <label id="lblBmi" runat="server">
                                        BMI:</label>
                                    <asp:TextBox ID="txtBMI" runat="server" MaxLength="3" Columns="4"></asp:TextBox>
                                </td>

                                <td align="center" style="width: 25%;" runat="server">
                                    <label>
                                        BP:</label>
                                    <asp:TextBox ID="txtBPSystolic" runat="server" MaxLength="3" Columns="4"></asp:TextBox>
                                    <label>
                                        /</label>
                                    <asp:TextBox ID="txtBPDiastolic" runat="server" MaxLength="3" Columns="4"></asp:TextBox>
                                    <span class="smallerlabel">(mm/Hg)</span>
                                </td>
                            </tr>
                        </table>
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg formcenter" id="tdPregnant" colspan="2" runat="server">
                        <table width="100%" border="0">
                            <tr align="center">
                                <td align="center"   style="width: 100%;display:inline-table">
                                    <label id="lblPregnant" runat="server">
                                        Pregnancy:
                                    </label>
                                    <asp:DropDownList ID="ddlpregnancy" onchange="fnchange()" runat="server">
                                    </asp:DropDownList>
                                    <span id="spanEDD" style="display: none">
                                        <label id="lblEDD" class="margin20" for="EDD">
                                            EDD:</label>
                                        <input id="txtEDD" runat="server" maxlength="11" size="11" />
                                        <img id="imgEDD" onclick="w_displayDatePicker('<%=txtEDD.ClientID%>');" height="22"
                                            alt="Date Helper" hspace="3" src="../images/cal_icon.gif" width="22" border="0">
                                        <span class="smallerlabel">(DD-MMM-YYYY)</span>
                                        <label id="lblanc" for="anc" class="margin20">
                                            ANC No:</label>
                                        <asp:TextBox ID="txtANCNumber" runat="server" MaxLength="4" Columns="13"></asp:TextBox>
                                        <label id="lblrefpmtct" class="margin20">
                                            Referred to PMTCT (ac):
                                        </label>
                                        <asp:CheckBox ID="chkrefpmtct" runat="server" />
                                    </span>
                                </td>
                            </tr>
                            <tr align="center">
                                <td align="center" style="width: 100%;">
                                    <span id="miscarriage" style="display: none">
                                        <label id="Label2" class="margin20">
                                            Date of Miscarriage:
                                        </label>
                                        <input id="txtdatemiscarriage" runat="server" maxlength="11" size="11" />
                                        <img id="img1" onclick="w_displayDatePicker('<%=txtdatemiscarriage.ClientID%>');"
                                            height="22" alt="Date Helper" hspace="3" src="../images/cal_icon.gif" width="22"
                                            border="0">
                                        <span class="smallerlabel">(DD-MMM-YYYY)</span> </span><span id="Abortion" style="display: none">
                                            <label id="Label3" class="margin20">
                                                Date of Induced Abortion:
                                            </label>
                                            <input id="txtdateinducedabortion" runat="server" maxlength="11" size="11" />
                                            <img id="img2" onclick="w_displayDatePicker('<%=txtdateinducedabortion.ClientID%>');"
                                                height="22" alt="Date Helper" hspace="3" src="../images/cal_icon.gif" width="22"
                                                border="0">
                                            <span class="smallerlabel">(DD-MMM-YYYY)</span> </span>
                                </td>
                            </tr>
                        </table>
                    </td>
                </tr>
                <tr>
                    <td class="border pad10 whitebg" valign="top" align="left" colspan="2" id="tdFamilyPlanning"
                        runat="server">
                        <table width="100%" border="0">
                            <tr align="center">
                                <td align="center" style="width: 50%;">
                                    <label class="margin20">
                                        Family Planning:</label>
                                    <asp:DropDownList ID="ddlFamilyPanningStatus" onchange="fnfamilyplanning();" runat="server">
                                    </asp:DropDownList>
                                    <div class="divborder checkbox" id="divFamilyPlanningMethod" style="display: none">
                                        <asp:Panel ID="PnlFamilyPlanningMethod" runat="server">
                                        </asp:Panel>
                                    </div>
                                </td>
                                <td align="center" valign="top" style="width: 50%;">
                                    <span id="notfamilyplanning" style="display: none">
                                        <label class="margin20">
                                            Reason Not on Family Planning:
                                        </label>
                                        <asp:DropDownList ID="ddlnotfamilyplanning" runat="server">
                                        </asp:DropDownList>
                                    </span>
                                </td>
                            </tr>
                        </table>
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg" colspan="2" width="100%" style="height: 35px">
                        <table width="100%" border="0">
                            <tr align="center">
                                <td style="width: 100%;" align="center">
                                    <label id="lblTBStatus" runat="server">
                                        TB Status:</label>
                                    <asp:DropDownList ID="ddlTBStatus" onchange="fnTBStatus();" runat="server">
                                    </asp:DropDownList>
                                    <span id="tbstartdate" style="display: none">
                                        <label>
                                            TB Treatment Start Date:
                                        </label>
                                        <input id="txttbstartdate" runat="server" maxlength="11" size="11" />
                                        <img id="img3" onclick="w_displayDatePicker('<%=txttbstartdate.ClientID%>');" height="22"
                                            alt="Date Helper" hspace="3" src="../images/cal_icon.gif" width="22" border="0">
                                        <span class="smallerlabel">(DD-MMM-YYYY)</span> </span><span id="tbtreatment" style="display: none">
                                            <label>
                                                TB Treatment #:
                                            </label>
                                            <input id="txtTBtreatmentNumber" maxlength="8" size="8" name="txtTBtreatmentNumber"
                                                runat="server">
                                        </span>
                                </td>
                            </tr>
                        </table>
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg" colspan="2" width="100%" style="height: 35px">
                        <table width="100%" border="0">
                            <tr>
                                <td class="border pad10 whitebg" width="50%" valign="top">
                                    <label class="margin20">
                                        Potential Side Effects:</label>
                                    <br />
                                    <div id="divPotentialSideEffect" class="divborder margin10" style="margin-top: 10;
                                        margin-bottom: 10">
                                        <asp:Panel ID="PnlPotentialSideEffect" runat="server">
                                        </asp:Panel>
                                    </div>
                                </td>
                                <td class="border pad10 whitebg" width="50%" valign="top">
                                    <label class="margin20">
                                        New OIs, Other Problems:</label>
                                    <br />
                                    <div class="divborder margin20" style="margin-top: 10; margin-bottom: 10">
                                        <asp:Panel ID="PnlNewOIsProblemsOther" runat="server">
                                        </asp:Panel>
                                    </div>
                                    <label class="margin20" id="lblNutritionalProblems" style="visibility:hidden" runat="server">
                                        Nutritional Problems:</label>
                                    <asp:DropDownList ID="ddlNutritionalProblems" style="visibility:hidden" runat="server">
                                    </asp:DropDownList>
                                </td>
                            </tr>
                        </table>
                    </td>
                </tr>
                <tr>
                    <td class="border pad10 whitebg" align="center" colspan="2" width="100%" valign="top">
                        <label id="lblWHOStage" runat="server">
                            WHO Stage:</label>
                        <asp:DropDownList ID="ddlWHOStage" runat="server">
                        </asp:DropDownList>
                    </td>
                </tr>
            </tbody>
        </table>
    </div>
    <br />
    <div class="border center formbg">
        <br>
        <table cellspacing="2" cellpadding="0" width="100%" border="0">
            <tr>
                <td style="width: 50%;">
                    <h2 id="H1" class="forms" align="left">
                        Pharmacy</h2>
                </td>
                <td style="width: 50%;">
                    <label class="margin10">
                        Use pharmacy form for INH dispensing and other medications dispensed.
                    </label>
                </td>
            </tr>
        </table>
        <table cellspacing="6" cellpadding="0" width="100%" border="0">
            <tbody>
                <tr>
                    <td class="form">
                        <table width="100%" border="0" cellpadding="0" cellspacing="0">
                            <tr align="left">
                                <td style="width: 30%; display: inline" align="left">
                                    <label class="margin10">
                                        CTX:
                                    </label>
                                    <label class="margin10">
                                        Adherence:
                                    </label>
                                    <asp:DropDownList ID="ddlCotrimoxazoleAdhere" runat="server">
                                    </asp:DropDownList>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    &nbsp;
                                </td>
                            </tr>
                            <tr align="left">
                                <td style="width: 100%; display: inline" align="left">
                                    <label class="margin10" id="lblARVDrugsAdhere" runat="server">
                                        ARV:
                                    </label>
                                    <label class="margin10">
                                        Adherence:
                                    </label>
                                    <asp:DropDownList ID="ddlarvdrugadhere" onchange="fnARVDrug();" runat="server">
                                    </asp:DropDownList>
                                    <label class="margin10">
                                        Why Poor/Fair:
                                    </label>
                                    <asp:DropDownList ID="ddlwhypoorfair" onchange="fnarvdrugother();" runat="server">
                                    </asp:DropDownList>
                                    <div id="divReasonARVDrugsother" style="display: none">
                                        <label class="right15">
                                            Other Reason:</label>
                                        <asp:TextBox ID="txtReasonARVDrugsPoorFairOther" runat="server" MaxLength="10" Columns="10"></asp:TextBox>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    &nbsp;
                                </td>
                            </tr>
                            <tr align="left">
                                <td style="width: 30%; display: inline" align="left">
                                    <label class="required margin10">
                                        *Subsituations/Interruption:
                                    </label>
                                    <asp:DropDownList ID="ddlsubsituationInterruption" onchange="fnSubsituations();"
                                        runat="server">
                                    </asp:DropDownList>
                                    <div id="arvTherapyChange" style="display: none">
                                        <label class="required margin10">
                                            *Change Regimen Reason:</label>
                                        <asp:DropDownList ID="ddlArvTherapyChangeCode" onchange="fnRegimenChange();" runat="server">
                                        </asp:DropDownList>
                                        <div id="otherarvTherapyChangeCode" style="display: none">
                                            <label class="required margin10" for="arvTherapyChangeCodeOtherName">
                                                *Specify:</label>
                                            <input id="txtarvTherapyChangeCodeOtherName" maxlength="20" size="10" name="arvTherapyChangeCodeOtherName"
                                                runat="server"></div>
                                    </div>
                                    <div id="arvTherapyStop" style="display: none">
                                        <label id="lblrARTdate" class="required margin10">
                                            *Date ART Ended</label>
                                        <input id="txtARTEndeddate" runat="server" maxlength="11" size="10" name="txtARTEndeddate" />
                                        <img id="imgdate" onclick="w_displayDatePicker('<%=txtARTEndeddate.ClientID%>');"
                                            height="22" alt="Date Helper" hspace="3" src="../images/cal_icon.gif" width="22"
                                            border="0" /><span class="smallerlabel">(DD-MMM-YYYY)</span>
                                        <br />
                                        <br />
                                        <label class="required margin10">
                                            *Stop Regimen Reason:</label>
                                        <asp:DropDownList ID="ddlArvTherapyStopCode" onchange="fnStopReason();" runat="server">
                                        </asp:DropDownList>
                                        <div id="otherarvTherapyStopCode" style="display: none">
                                            <label class="required margin10" for="arvTherapyStopCodeOtherName">
                                                *Specify:</label>
                                            <input id="txtarvTherapyStopCodeOtherName" maxlength="20" size="10" name="arvTherapyStopCodeOtherName"
                                                runat="server"></div>
                                    </div>
                                </td>
                            </tr>
                        </table>
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg center">
                        <div id="divAdultPharmacy" runat="server">
                             <asp:button id="btnpharmacy"  Text="Prescribe Drugs" runat="server" 
                                 onclick="btnpharmacy_Click"></asp:button>
                        </div>
                        
                    </td>
                </tr>
            </tbody>
        </table>
    </div>
    <br />
    <div class="border center formbg">
        <br>
        <table cellspacing="2" cellpadding="0" width="100%" border="0">
            <tr>
                <td style="width: 50%;">
                    <h2 id="H2" class="forms" align="left">
                        Laboratory Investigations</h2>
                </td>
                <td style="width: 50%;">
                    <label class="margin10">
                        Use lab order test button to order labs and document results.
                    </label>
                </td>
            </tr>
        </table>
        <table cellspacing="6" cellpadding="0" width="100%" border="0">
            <tbody>
                <tr>
                    <td class="border pad5 whitebg formcenter" align="center" colspan="2">
                        <div id="divLaboratory" runat="server">
                        <asp:Button ID="btnLabratory" Text="Laboratory" runat="server" 
                                onclick="btnLabratory_Click" />
                            
                        </div>
                        <div id="divLabOrderTest" runat="server">
                        <asp:Button ID="btnOrderLabTest" Text="LabOrderTest" runat="server" 
                                onclick="btnOrderLabTest_Click" />
                            
                        </div>
                    </td>
                </tr>
            </tbody>
        </table>
    </div>
    <br />
    <div class="border center formbg">
        <br>
        <h2 id="H3" class="forms" align="left">
            Referrals and Consultations</h2>
        <table cellspacing="6" cellpadding="0" width="100%" border="0">
            <tbody>
                <tr>
                    <td class="border pad10 whitebg" valign="top" width="50%">
                        <label class="margin20">
                            Referred To:
                        </label>
                        <div class="divborder margin20" style="margin-top: 10; margin-bottom: 10">
                            <div>
                                <asp:Panel ID="PnlReferredTo" runat="server">
                                </asp:Panel>
                            </div>
                        </div>
                    </td>
                    <td class="border pad5 whitebg" align="center">
                        <label id="Label17" class="margin15">
                            # of Days Hospitalized:</label>
                        <asp:TextBox ID="txtNumOfDaysHospitalized" runat="server" MaxLength="4" Columns="4"></asp:TextBox>
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg" align="center" width="50%">
                        <label>
                            Nutritional Support:</label>
                        <asp:DropDownList ID="ddlNutritionalSupport" runat="server">
                        </asp:DropDownList>
                    </td>
                    <td id="tdInfantFeedingPractice" style="display:none" runat="server" class="border pad5 whitebg" align="center">
                        <label>
                            Infant Feeding Practice:</label>
                        <asp:DropDownList ID="ddlInfantFeedingPractice" runat="server">
                        </asp:DropDownList>
                    </td>
                </tr>
            </tbody>
        </table>
    </div>
    <br />
    <div class="border center formbg">
        <br>
        <h2 id="H4" class="forms" align="left">
            Positive Prevention
        </h2>
        <table cellspacing="6" cellpadding="0" width="100%" border="0">
            <tbody>
                <tr>
                    <td class="border pad10 whitebg" valign="top" width="50%">
                        <label>
                            At Risk Population:
                        </label>
                        <div class="divborder margin20" style="margin-top: 10; margin-bottom: 10">
                            <div>
                                <asp:Panel ID="pnlriskpopulation" runat="server">
                                </asp:Panel>
                            </div>
                        </div>
                    </td>
                    <td class="border pad10 whitebg" valign="top" width="50%">
                        <label>
                            At Risk Population Services:
                        </label>
                        <div class="divborder margin20" style="margin-top: 10; margin-bottom: 10">
                            <div>
                                <asp:Panel ID="pnlriskpopulationservice" runat="server">
                                </asp:Panel>
                            </div>
                        </div>
                    </td>
                </tr>
                <tr>
                    <td class="border pad10 whitebg" valign="top" width="50%">
                        <label>
                            Prevention with positives (PwP):
                        </label>
                        <div class="divborder margin20" style="margin-top: 10; margin-bottom: 10">
                            <div>
                                <asp:Panel ID="pnlprewithpositive" runat="server">
                                </asp:Panel>
                            </div>
                        </div>
                    </td>
                    <td class="border pad10 whitebg" valign="top" width="50%">
                    </td>
                </tr>
                <tr>
                    <td class="border pad5 whitebg" align="center" width="50%">
                        <label id="lblNextAppointment" class="center" runat="server">
                            Date of Next Appointment:
                        </label>
                        <input id="txtdatenextappointment" runat="server" maxlength="11" size="11" />
                        <img id="img4" onclick="w_displayDatePicker('<%=txtdatenextappointment.ClientID%>');"
                            height="22" alt="Date Helper" hspace="3" src="../images/cal_icon.gif" width="22"
                            border="0">
                        <span class="smallerlabel">(DD-MMM-YYYY)</span>
                    </td>
                    <td class="border pad5 whitebg" align="center" width="50%">
                        <label>
                            Attending Clinician:
                        </label>
                        <asp:DropDownList ID="ddlattendingclinician" runat="server">
                        </asp:DropDownList>
                    </td>
                   
                </tr>
                <tr>
                    <td class="form" colspan="2">
                        <asp:Panel ID="pnlCustomList" Visible="false" runat="server" Height="100%" Width="100%"
                            Wrap="true">
                        </asp:Panel>
                    </td>
                </tr>
                <tr>
                    <td class="pad5 center whitebg border" colspan="2">
                        <br>
                        <asp:Button ID="btnSave" Text="Save" runat="server" OnClick="btnSave_Click" />
                        <asp:Button ID="btnDataQualityCheck" Text="Data Quality check" runat="server" 
                            onclick="btnDataQualityCheck_Click" />
                        <asp:Button ID="btnClose" Text="Close" runat="server" 
                            onclick="btnClose_Click" />
                        <asp:Button ID="btnPrint" Text="Print" runat="server" OnClientClick="WindowPrint()" />
                    </td>
                </tr>
            </tbody>
        </table>
    </div>
  </div>
</asp:Content>
